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Nuclear magnetic resonance (NMR) imaging of intracerebral hemorrhage in the acute and resolving phases.

Nuclear magnetic resonance imaging of intracerebral hemorrhage revealed a considerable difference in the appearance of the bleedings in the acute and resolving phases. Attention is drawn to the shortening of the relaxation time T1 within the first 2 weeks after the acute onset of symptoms with the location of the change at the periphery of the lesion. The change was most evident with T1 dependent inversion recovery sequence (IR 1,500/400). With this pulse scheme the acute hemorrhage was visualized as a dark area during its early days. A bright zone, reflecting the shorter T1, was not seen until the resolving phase at the end of the 1st week. Although its pathophysiological aspects are so far unknown, this finding may offer an opportunity for dating intracerebral hemorrhages.

Acute Disease↗

Accelerated myelination in early Sturge-Weber syndrome demonstrated by MR imaging.

Magnetic resonance imaging of the brain in two infants with Sturge-Weber syndrome has demonstrated a pattern of accelerated myelination in the abnormal cerebral hemisphere. The extent of myelination was most apparent on the T1-weighted inversion recovery sequence while the T2-weighted images demonstrated concomitant changes in hydration of the brain. We propose an explanation for this finding based on cerebral ischemia underlying the leptomeningeal angioma.

Angiomatosis↗

The effects of eccentric velocity on activation of elbow flexors: evaluation by magnetic resonance imaging.

PURPOSE: To compare magnetic resonance imaging (MRI) signal intensity changes in the primary elbow flexors during two isotonic exercise protocols varying in eccentric velocity and the ratio of eccentric to concentric activity. METHODS: Twelve men performed two exercise protocols. The right and left arms were randomly assigned to one of two protocols that had the same workload (60% 1RM) and same total time of exercise (144 s) but differed in the velocity and ratio of eccentric to concentric activity (1:1 and 5:1 for the fast and slow protocols, respectively). MRI signal intensity changes were quantified pre- and post-exercises using an inversion recovery sequence with a 1.5T MRI system (TR = 2500 ms, TE = 90 ms, TI = 140 ms). Percent change in MRI signal intensity, rate of perceived exertion (RPE), and delayed onset muscle soreness (DOMS) were recorded and analyzed. RESULTS: The biceps brachii was found to be preferentially recruited during the fast protocol compared with the brachialis, whereas the brachialis was found to be preferentially recruited during the slow protocol (P < 0.05). The fast exercise protocol was perceived as being more strenuous (RPE = 8.3 +/- 2.1) than the slow (RPE = 5.4 +/- 1.5, P < 0.05) and produced DOMS in 58% of the tested subjects. CONCLUSIONS: These results suggest that agonists respond to various loading conditions nonhomogeneously. These findings may have implications with respect to exercise prescriptions for specific muscles.

Adult↗

Ulnar nerve entrapment at the elbow: correlation of magnetic resonance imaging, clinical, electrodiagnostic, and intraoperative findings.

The diagnosis of ulnar nerve entrapment at the elbow has relied primarily on clinical and electrodiagnostic findings. Recently, magnetic resonance imaging (MRI) has been used in the evaluation of peripheral nerve entrapment disorders to document signal and configuration changes in nerves. We performed a prospective study on a population of 31 elbows in 27 patients with ulnar nerve entrapment at the elbow. The study correlated MRI findings with clinical, electrodiagnostic, and operative findings. A control population consisting of 10 asymptomatic subjects also was studied by MRI. Electrodiagnostic evaluation confirmed ulnar neuropathy in 24 (77%) elbows of the 31, with localization to the elbow region in 21 (68%). MRI, using a short tau inversion recovery sequence, demonstrated increased signal of the ulnar nerve in 30 (97%) elbows of the 31 and enlargement of the ulnar nerve in 23 (74%). No MRI abnormalities were found in the control population. MRI signal increase of the ulnar nerve occurred an average of 27 mm proximal to the distal humerus and extended distally an average of 4 mm below the distal humerus. The mean total length of increased ulnar nerve signal was 34 mm. Ulnar nerve enlargement occurred an average of 19 mm proximal to the distal humerus and extended distally an average of 8 mm above the distal humerus. The mean total length of ulnar nerve enlargement was 12 mm. The 12 patients who underwent a surgical procedure for ulnar nerve entrapment were found to have ulnar nerve compression, with 9 (75%) having excellent and 3 (25%) having good postoperative results. In this study, MRI was both sensitive and specific in diagnosing ulnar nerve entrapment at the elbow as defined by clinical, electrodiagnostic, and operative findings.

Adult↗

Magnetic resonance imaging-based stereotactic localization of the globus pallidus and subthalamic nucleus.

OBJECTIVE: To optimize the accuracy of initial stereotactic targeting for movement disorders surgery, we performed stereotactic localization of the internal segment of the globus pallidus (GPi) and subthalamic nucleus (STN) using magnetic resonance imaging protocols in which the borders of these nuclei were directly visualized. METHODS: Fifty-one consecutive cases using the pallidal target and six using the subthalamic target were studied. Localization of these nuclei was performed using the Leksell stereotactic head frame and inversion recovery sequences (GPi) or T2-weighted spin echo sequences (STN). Targeting accuracy and individual variation in the spatial coordinates of these structures were independently measured by identification of nuclear boundaries during multiple microelectrode penetrations. RESULTS: The lateral and vertical coordinates of an atlas-defined point in the GPi, with respect to the line between the anterior and posterior commissures, was highly variable. Initial targeting the GPi based on direct visualization of the target boundaries (external medullary lamina and optic tract) resulted in greater precision than would be expected using fixed anterior and posterior commissure-based coordinates. Initial targeting the STN using magnetic resonance imaging was sufficiently precise to place the initial microelectrode penetration within STN in all six cases. CONCLUSION: Magnetic resonance imaging-based initial stereotactic targeting of the GPi, based on direct visualization of the target boundaries, is useful to improve target accuracy over that of purely indirect anterior and posterior commissure-based targeting methods. Initial targeting of the STN was reliably accomplished by direct visualization. However, there remains sufficient variability that the final target location in both GPi and STN required electrophysiological mapping in all cases.

Brain Mapping↗

Questioning the sensitivity of magnetic resonance imaging in early septic spondylodiscitis.

Septic spondylodiscitis is an uncommon disease, but one with serious complications and potentially high morbidity and mortality. The diagnosis is sometimes delayed, particularly in those patients with an insidious mode of onset and nonspecific symptoms. Several imaging methods are available to facilitate the early diagnosis of septic spondylodiscitis, and of these methods magnetic resonance imaging (MRI) has been reported to be the most sensitive, revealing abnormalities earlier than plain x-ray, gallium scan and bone scan. We report a case of septic spondylodiscitis in which MRI did not demonstrate evidence of discitis after a symptom period of seven days. The diagnosis was later confirmed by bone scan and repeat MRI. We suggest that a negative or equivocal MRI cannot exclude infective spondylodiscitis, especially in the early stages of the disease process. In such cases, it is important to note that the addition of a short tau-inversion recovery sequence will increase the sensitivity of MRI, and, additionally, gadolinium should be administered if the magnetic resonance study is negative and a strong clinical suspicion of spondylodiscitis exists.

Journal Article↗

MRI and muscle signal intensities in alcoholics compared with control subjects.

OBJECTIVE: To evaluate by magnetic resonance imaging (MRI) the difference in muscle signal intensities between alcoholics and control subjects. METHODS: Thirty-four healthy subjects and 46 alcohol-dependent individuals were assessed. MRI was carried out using a low-field magnet (0.2 Tesla) and a limb-dedicated coil. The presence of muscle changes was evaluated by measuring signal intensities at the medial (MG) and lateral heads of the gastrocnemius muscle by T1-/T2-weighted and gradient-echo short tau inversion recovery sequences. The mean signal intensities of the two sample groups were compared by ANCOVA with age as a covariate. In the alcohol-dependent group, correlations between signal intensities and plasma levels of muscular and hepatic enzymes, in addition to years of high-risk consumption and lifetime dose of ethanol consumed, were assessed. The mean signal intensities were also compared with the different degrees of pain by ANOVA. RESULTS: Compared with healthy subjects, the alcohol-dependent group had mean higher signal intensities in both gastrocnemius heads in all sequences. The difference in the MG in T2-weighted sequences was significant (F = 48.28, p < 0.01). A modest correlation between the years of high-risk consumption and the signal intensity was found in T2-weighted sequences in the MG (r = 0.288, p = 0.057), whereas a correlation with the lifetime dose consumed was not found. Significant correlations between signal intensities and plasma levels of muscular and hepatic enzymes were not found. There were also no significant group differences on different degrees of pain. CONCLUSION: MRI was shown to be a sensitive, well-tolerated, and inexpensive procedure capable of detecting changes in signal intensities in the muscles of alcoholics. This technique could be included among other diagnostic tools for alcoholic myopathy with further improvements and if the signal alterations can be corroborated by biopsy evidence.

Adult↗

Purification, properties and kinetic mechanism of flavonol 8-O-methyltransferase from Lotus corniculatus L.

A novel O-methyltransferase catalyzing the transfer of the methyl group of S-adenosyl-L-methionine to the 8-hydroxyl group of flavonols was purified about 1200-fold from Lotus flower buds, by precipitation with ammonium sulfate and successive chromatography on columns of Sephadex G-100, S-adenosyl-L-homocysteine--Agarose, hydroxyapatite and Polybuffer ion exchanger. The enzyme exhibited strict specificity for position 8 of 8-hydroxyquercetin and 8-hydroxykaempferol, a pH optimum at 7.9, a pI value of 5.5, an Mr of 55 X 10(3) and required Mg2+ and SH groups for activity. The Km values for 8-hydroxykaempferol and S-adenosyl-L-methionine were 1.3 microM and 53 microM, respectively. The data obtained from substrate interaction and product inhibition studies are expected for a steady-state ordered bi-bi mechanism, with 8-hydroxyflavonol binding before S-adenosyl-L-methionine followed by the release of S-adenosyl-L-homocysteine and 8-methoxyflavonol. An alternative mechanism that may also fit the data is the mono-iso Theorell-Chance with the inverse binding sequence and an isomerization step of the free enzyme.

Buffers↗

Self-contained, inflatable penile prosthesis: magnetic resonance appearance.

The appearance of an inflatable penile prosthesis, visualized on a short tau inversion recovery sequence, is reported, in a patient who had magnetic resonance imaging for pelvic pain subsequent to radical cystoprostatectomy for bladder carcinoma. With suppression of adjacent fat signal, the prosthesis is well delineated from adjacent structures. The fluid-containing cylinders of the prosthesis are of very bright signal intensity, with the relief valve assembly of low signal intensity.

Humans↗

Cloning and characterization of a glycosyltransferase gene involved in the biosynthesis of anthracycline antibiotic beta-rhodomycin from Streptomyces violaceus.

A glycosyltransferase gene, rhoG, involved in the biosynthesis of the anthracycline antibiotic beta-rhodomycin was isolated as a 4.1-kb DNA fragment containing rhoG and its flanking region from Streptomyces violaceus by degenerate and inverse PCR. Sequencing analysis showed that rhoG was located in a gene cluster involved in the biosynthesis of the constitutive deoxysugar of beta-rhodomycin. The function of rhoG was verified by gene disruption, which was generated by replacing the internal 0.9-kb region of S. violaceus chromosome with a fragment including the SacI-blunted region. The rhoG disruption resulted in complete loss of beta-rhodomycin productivity, along with the accumulation of a non-glycosyl intermediate epsilon-rhodomycinone. In addition, the complementation test demonstrated that rhoG restored beta-rhodomycin production in this gene disruptant. These results indicated that rhoG is the glycosyltransferase gene responsible for the glycosylation of epsilon-rhodomycinone in beta-rhodomycin biosynthesis.

Anthracyclines↗

Low-field magnetic resonance imaging of a pyocephalus and a suspected brain abscess in a German Shepherd dog.

Magnetic resonance imaging was performed on an eight-year-old, neutered female German Shepherd dog with a history of acute depression, inappetence, and hyperthermia. A lesion in the cerebrum was suspected. Possible differential diagnoses were meningoencephalitis, neoplasia, and vascular lesion (infarction, bleeding). A ring enhancing lesion was found in the basal ganglia on the left side with edema of the surrounding brain tissue. A similar mass lesion was present in the right pterygoid musculature. With inversion recovery sequences an altered composition of the cerebrospinal fluid (CSF) in the left lateral ventricle could be detected. CSF analysis confirmed a pyocephalus, probably due to rupture of a brain abscess into the left lateral ventricle.

Animals↗

Intraluminal ultrasound applicator compatible with magnetic resonance imaging "real-time" temperature mapping for the treatment of oesophageal tumours: an ex vivo study.

High intensity ultrasound has shown considerable ability to produce precise and deep thermal coagulation necrosis. Focused, cylindrical, spherical or plane transducers have been used to induce high temperatures in tissues to coagulate proteins and kill cells. Recently magnetic resonance imaging (MRI) has been used, with extracorporeal or intracavitary focused transducers and cylindrical interstitial applicators, to monitor temperature distribution and provide feedback during heating procedures. If intraluminal applicators are used, the active part is in contact with the region of interest and it is essential to provide an accurate view of heat deposition and the extent of coagulation necrosis close to the transducer. The purpose of this study was to develop a 10 mm diameter intraluminal ultrasound applicator, designed to treat oesophageal cancers and compatible with MRI "real-time" temperature mapping. The active part of the ultrasound applicator, covered by a latex balloon, is a 15 X 8 mm2 plane transducer, which is in contact with the tumours during treatment. Each ultrasound exposure generates coagulation necrosis, in an area with the approximate shape of a rectangular parallelepiped up to 10 mm deep. When the exposures were repeated by rotating the applicator on its axis, sector-based or cylindrical volumes of necrosis could be produced, matching the shape of oesophageal cancers. Ex vivo trials were performed to demonstrate the applicator's compatibility with a clinical MRI scanner (1.5 T). MRI signals were acquired without any magnetic susceptibility distortion, even close to the applicator. Fast (0.72 images per second) 2D temperature mapping was performed during ultrasound exposure, using temperature-related proton resonance frequency shift at a resolution of 0.5 degrees C. Coagulation necrosis viewed with inversion recovery sequences, were in good agreement with the qualitative macroscopic observations made for the few cases tested in this study.

Agar↗

Relaxation rates of paramagnetic solutions: evaluation by nuclear magnetic resonance imaging.

Methods for accurate calculation of nuclear magnetic resonance relaxation times are presented. Data from inversion recovery sequences with different delay times were fitted to derive T1 information on water solutions of paramagnetic ions. T2 values of the same samples were obtained by fitting signals from a multiecho sequence. According to the theory, for the field strength used (0.5 T), T1's and T2's are nearly equal and the enhancement of relaxation rates is found to be directly proportional to molar concentration. Tests performed suggest the opportunity of using the same approach in studies of tissues.

Biometry↗

Toward an automated analysis system for nuclear magnetic resonance imaging. I. Efficient pulse sequences for simultaneous T1-T2 imaging.

Simultaneous T1 and T2 images have been obtained using multiple-echo self-normalizing sequences. Differential T1 and T2 discrimination for two of these sequences, double saturation recovery and inversion-saturation recovery, have been explored in detail. The inversion-saturation recovery sequence exhibits T1 discrimination comparable to, and in many cases better than, that of optimal T1 weighted conventional pulse sequences, but is poor for T2 imaging. The double saturation recovery sequence yields comparable tissue discrimination for T1 and T2 imaging, but is poor compared to optimal T1 weighted and T2 weighted conventional pulse sequences. Simultaneous T1 and T2 images represent quantitative maps of intrinsic tissue properties, and hence form a natural basis for an automated image analysis and tissue classification system.

Brain↗

Changes in structure and methylation pattern in a cluster of thymidine kinase genes.

Cell line 101 is a thymidine kinase (TK)-positive derivative of Ltk- which contains ca. 20 copies of the herpes simplex virus TK gene organized in a tandem array. DNA methylation at three sites within the gene and flanking sequences was inversely correlated with expression: the sites were unmethylated in line 101, methylated in each of 4 TK-negative derivatives of 101, and unmethylated in each of 21 TK-positive derivatives derived from them. The same three sites were affected in most of the 20 copies of the TK gene, whereas other sites between them were not affected. Although the entire gene cluster was never lost, indicating that integration into the genome was stable, internal rearrangements occurred at a high frequency. The rearrangements had no obvious correlation with the state of methylation or with the expression of the genes.

Animals↗

Delayed hyperenhancement in magnetic resonance imaging of left ventricular hypertrophy caused by aortic stenosis and hypertrophic cardiomyopathy: visualisation of focal fibrosis.

OBJECTIVE: To compare the extent and distribution of focal fibrosis by gadolinium contrast-enhanced magnetic resonance imaging (MRI; delayed hyperenhancement) in severe left ventricular (LV) hypertrophy in patients with pressure overload caused by aortic stenosis (AS) and with genetically determined hypertrophic cardiomyopathy (HCM). METHODS: 44 patients with symptomatic valvular AS (n = 22) and HCM (n = 22) were studied. Cine images were acquired with fast imaging with steady-state precession (trueFISP) on a 1.5 T scanner (Sonata, Siemens Medical Solutions). Gadolinium contrast-enhanced MRI was performed with a segmented inversion-recovery sequence. The location, extent and enhancement pattern of hyperenhanced myocardium was analysed in a 12-segment model. RESULTS: Mean LV mass was 238.6 (SD 75.3) g in AS and 205.4 (SD 80.5) g in HCM (p = 0.17). Hyperenhancement was observed in 27% of patients with AS and in 73% of patients with HCM (p < 0.01). In AS, hyperenhancement was observed in 60% of patients with a maximum diastolic wall thickness >or= 18 mm, whereas no patient with a maximum diastolic wall thickness < 18 mm had hyperenhancement (p < 0.05). Patients with hyperenhancement had more severe AS than patients without hyperenhancement (aortic valve area 0.80 (0.09) cm(2)v 0.99 (0.3) cm(2), p < 0.05; maximum gradient 98 (22) mm Hg v 74 (24) mm Hg, p < 0.05). In HCM, hyperenhancement was predominant in the anteroseptal regions and patients with hyperenhancement had higher end diastolic (125.4 (36.9) ml v 98.8 (16.9) ml, p < 0.05) and end systolic volumes (38.9 (18.2) ml v 25.2 (1.7) ml, p < 0.05). The volume of hyperenhancement (percentage of total LV myocardium), where present, was lower in AS than in HCM (4.3 (1.9)% v 8.6 (7.4)%, p< 0.05). Hyperenhancement was observed in 4.5 (3.1) and 4.6 (2.7) segments in AS and HCM, respectively (p = 0.93), and the enhancement pattern was mostly patchy with multiple foci. CONCLUSIONS: Focal scarring can be observed in severe LV hypertrophy caused by AS and HCM, and correlates with the severity of LV remodelling. However, focal scarring is significantly less prevalent in adaptive LV hypertrophy caused by AS than in genetically determined HCM.

Aortic Valve Stenosis↗

Magnetic resonance imaging in Leber's optic neuropathy.

Thirteen males with Leber's optic neuropathy had magnetic resonance imaging (MRI) of the brain, and in eight the optic nerves were imaged using STIR (Short Time Inversion Recovery) sequences. All optic nerve scans were abnormal. In seven with bilateral visual loss four showed bilateral increased optic nerve signal and three unilateral increase. The involvement was of the mid and posterior intra-orbital sections over three 5 mm slices or more with sparing of the anterior portion. One patient with unilateral visual loss had increased signal only on the affected side. Brain MRI was normal, in marked contrast to the findings in clinically isolated optic neuritis in which multiple white matter lesions are seen in the majority.

Adult↗

Radiologic spectrum of craniocervical distraction injuries.

Injuries to the atlanto-occipital region, which range from complete atlanto-occipital or atlantoaxial dislocation to nondisplaced occipital condyle avulsion fractures, are usually of critical clinical importance. At initial cross-table lateral radiography, measurement of the basion-dens and basion-posterior axial line intervals and comparison with normal measurements may help detect injury. Computed tomography (CT) with sagittal and coronal reformatted images permits optimal detection and evaluation of fracture and luxation. CT findings that may suggest atlanto-occipital injury include joint incongruity, focal hematomas, vertebral artery injury, capsular swelling, and, rarely, fractures through cranial nerve canals. Magnetic resonance (MR) imaging of the cervical spine with fat-suppressed gradient-echo T2-weighted or short-inversion-time inversion recovery sequences can demonstrate increased signal intensity in the atlantoaxial and atlanto-occipital joints, craniocervical ligaments, prevertebral soft tissues, and spinal cord. Axial gradient-echo MR images may be particularly useful in assessing the integrity of the transverse atlantal ligament. All imaging studies should be conducted with special attention to bone integrity and the possibility of soft-tissue injury. Atlanto-occipital injuries are now recognized as potentially survivable, although commonly with substantial morbidity. Swift diagnosis by the trauma radiologist is crucial for ensuring prompt, effective treatment and preventing delayed neurologic deficits in patients who survive such injuries.

Atlanto-Axial Joint↗